Subjective (S): “My arms get tired, I have shoulder pain, and I get short of bre
ID: 244778 • Letter: S
Question
Subjective (S): “My arms get tired, I have shoulder pain, and I get short of breath pushing my wheelchair up inclines. Also, I sometimes suffer from a rapid onset of anxiousness, sweating, headache, and pupil dilation (my girlfriend noticed the pupil dilation). These signs/symptoms occurred several times during rehabilitation as my pressure sores were healing, or whenever my bladder was full.”
3. Ted describes random bouts of anxiety, sweating, headache, and pupil dilation. What condition is Ted describing? Why does this condition occur, and what are the potential triggers associated with the signs and symptoms Ted described? Does this condition occur in all patients diagnosed with a spinal cord injury?
Explanation / Answer
Ted is affected with the condition called Autonomic dysreflexia. People affected with spinal cord injury above sixth thoracic vertebra usually get this problem. The Autonomic nervous system includes sympathetic and para sypmathetic nervous system both are responsible for controlling involuntary bodily actions like breathing, digestion, body temperature, metabolism, elimination and sexual response etc., Usually when sypmathetic nervous system over react parasympathetic nervous system will compensate for it. In Ted condition the sympathetic nervous will over react to the stimuli like full bladder the parasympathetic nervous system can't effectively stop that reaction. Due to spinal cord injury the nerve impulses can't pass through the spinal cord to the brain.
Potential triggers associated with the Ted's signs and symptoms:
A distended bladder
A blocked catheter
Urinary retention
Urinary tract infection
Bladder stone
Constipation
A bowel impaction
Haemorrhoids
Skin irritation
Pressure sore